本文關鍵詞： 咬合 T-Scan 咬肌 胸鎖乳突肌 表面肌電信號 咬合力 下頜運動軌跡描記儀　出處：《第四軍醫(yī)大學》2015年碩士論文　論文類型：學位論文

【摘要】：胸鎖乳突肌(sternocleidomastoid muscle,SCM)的主要功能之一是產(chǎn)生頭頸運動,頸肌與咀嚼肌構成不同層級的肌鏈[1]。胸鎖乳突肌是否也參與了咀嚼運動,其與咬肌功能活動以及咬合力水平、咀嚼時相有怎樣的關系尚不清楚。由于咬肌功能活動與咬合密切相關,如果胸鎖乳突肌與咬肌功能相關,無疑將對頸椎功能紊亂病的咬合病因研究提供重要線索。本研究采用T-scan III咬合記錄儀和Bio EMG III肌電圖儀,同步記錄25名健康受試者的SCM肌電值,分析在不同程度咬合力時SCM肌電值與自主最大緊咬(maximal voluntary clenching,MVC)時肌電值的比值的變化,并以咬肌(masseter muscles,MM)為參照,探索在牙尖交錯位作最大緊咬的過程中,SCM肌電水平與咬合力之間的關系;然后采用Bio EMG III肌電圖儀和下頜運動軌跡描記儀(EGN),同步記錄20名健康受試者單側咀嚼運動時的雙側SCM和MM的肌電及咀嚼運動軌跡,分析、比較SCM和MM肌電峰值在咀嚼運動軌跡上的所處位置。結果表明:1、MVC時,不僅雙側MM而且雙側SCM都有明顯的肌電活動,左右側SCM及MM肌電值均無明顯差異;SCM肌電幅值約為MM的9.13±4.77%~10.23±6.47%;SCM及MM的肌電比值在達到最大咬合力的75%之前均呈逐漸增高趨勢,但從最大咬合力的75%水平至MVC時肌電值顯著下降(P0.05)。2、單側咀嚼時,雙側SCM與MM均在最終咀嚼位(TCP)之前出現(xiàn)峰值電位,但SCM的肌電峰值水平很小,在單側咀嚼時僅為MM的6.95±3.48%~7.78±4.57%;平衡側SCM的肌電早于平衡側和工作側MM肌電達峰,而工作側SCM與雙側MM肌電峰值出現(xiàn)的時間沒有明顯差異。由于對稱性正中緊咬時SCM與MM表現(xiàn)出同步活動特征,而非對稱的單側咀嚼時SCM與MM峰值電位不同步,平衡側SCM峰值電位提前發(fā)生,以穩(wěn)定頭頸姿勢,為咬肌發(fā)揮咀嚼力提供穩(wěn)定的頸部姿勢環(huán)境。因此本文得出以下結論:1、SCM參與了正中緊咬和咀嚼運動,在正中緊咬和咀嚼運動中,SCM與MM具有協(xié)同作用關系。2、平衡側SCM在單側咀嚼時頭頸姿勢的穩(wěn)定方面發(fā)揮著重要作用。
[Abstract]:The sternocleidomastoid muscle (sternocleidomastoid muscle SCM) is one of the main functions of head and neck movement, muscle and masseter muscles constitute different levels of muscle chain [1]. chest sternocleidomastoid muscle is involved in mastication, the masseter muscle and functional activity and bite force, chewing is what kind of relationship is not clear. Because of the masseter muscle functional activity and occlusion are closely related, if the sternocleidomastoid muscle and masseter muscle function, will undoubtedly cause study on occlusal disorders of the cervical spine disease provide important clues. This study uses T-scan III and Bio EMG III occlusion recorder EMG instrument, simultaneous recording of SCM EMG in 25 healthy subjects, analysis in different degree when the SCM value of EMG and bite force independent (maximal voluntary clenching, the largest set of MVC) when the ratio of the value of EMG changes in masseter muscle (masseter, muscles, MM) as a reference, to explore in the intercuspal position During maximal clenching in SCM EMG level and bite force were discussed; then using Bio EMG III electromyography and mandibular kinesiography (EGN), electromyography recorded 20 healthy subjects unilateral mastication and bilateral SCM MM and chewing movement, analysis, comparison and SCM the MM peak position in masticatory EMG trajectories. The results showed that: 1, MVC, MM and EMG activity not only bilateral had bilateral SCM, left and right side of the SCM and MM EMG values were not significantly different; SCM EMG amplitude was about 9.13 of MM + 4.77%~10.23 + 6.47%; the ratio of SCM and EMG before MM in the maximum bite force of 75% showed a gradually increasing trend, but the maximum bite force level of 75% to MVC EMG value decreased significantly (P0.05).2, unilateral mastication, bilateral SCM and MM are in the final position (TCP) before chewing peak potential, but EMG peak of SCM. The level of value is very small, the chewing is only 6.95 of MM + 3.48%~7.78 + 4.57%; balance EMG side SCM earlier than the balance side and work side MM EMG peak, there was no significant difference between the working side SCM and bilateral MM EMG peak time. Due to the symmetry of the median SCM and MM showed the clenching synchronization activity characteristics, rather than the SCM and MM peak voltage is not synchronous symmetrical unilateral chew, balanced side SCM peak potential occur in advance to stabilize the head and neck posture, to provide a stable neck posture of masseter muscle play environment masticatory force. So this paper draws the following conclusions: 1, SCM in the median clenching and chewing movement, in the middle of clenching and masticatory movement, SCM and MM has a synergistic effect between.2, plays an important role in stabilizing the balance side of head and neck SCM in unilateral mastication posture.

【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R782.63

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本文編號：1512741